PQRI Made Easy By Kelly Skinner and Claudia Tannous

Transcription

1 PQRI Made Easy By Kelly Skinner and Claudia Tannous What is PQRI and why should we do it? PQRI stands for: Physician Quality Reporting Initiative PQRI has been developed to provide physicians with an opportunity to receive enhanced payments from CMS and understand how your patients are doing using evidence based process and outcome measures. Bonus payment for 2010 is 2% of the participant s Medicare part B physician fee schedule total estimated allowed charges. For 2011 it will be 1%. For , it will be 0.5%. Beginning in 2015, those who do not report will be subject to payment adjustment equal to 1.5% of Medicare allowable. In 2016, it will be an adjustment of 2.0%. How to report PQRI Claims based reporting. Qualified Registry reporting. EHR-based Submission. 1

2 There are 179 quality measures available. There are 13 measure groups. We are going to concentrate today on the 13 measure groups with registry based submission through the AOA. CMS Measure Groups for Registry Reporting 1. Back Pain 2. Chronic Kidney Disease 3. Community-acquired Pneumonia 4. Coronary Artery Bypass Graft 5. Coronary Artery Disease 6. Diabetes Mellitus 7. Heart Failure 8. Hepatitis C 9. HIV/AIDS 10. Ischemic Vascular Disease 11. Preioperative Care 12. Preventive Care 13. Rheumatoid Arthritis Go to Click on the login button 2

3 Enter your username & password. Click on Log In Click on Continuing Medical Education Click on Physician Quality Reporting Initiative 3

4 To help you choose your Measure Group scroll to the bottom of the PQRI screen and click on a measure group for the instructions and the patient visit form. Click on AOA members log in and register for $199 Click on Members Click Here 4

5 Click on the down arrow and choose Physician then click on Choose a Profession to Continue Click on Start Now Click on Login 5

6 Enter your AOA ID and Password Once you login you will need to choose AOA CAP for PQRI 2010 This will open a new window. Click on Get Started This will open a new window. 6

7 Enter your National Provider Identifier and your Tax Identification Number and click Next. It will ask you to verify your information and click Next. This will take you to an agree screen. You will need to click both agree boxes on this screen and click Next. Enter your payment information and click on Next Once you enter your payment information it will bring up a receipt for your transaction. You will want to print this for your records. 7

8 Choose one of the 13 measure groups and click on Next. This will take you to a screen to choose your reporting period. Choose the period you want to report on and click on Next. When you have made your group choice it will bring up a set of instructions and a form for each measure. You MUSTSTOPhere and print out the attestation, fill out the form and fax it to AOA before you can enter any data. This will take a couple of business days for your data to be updated. Once you get to this screen if you have not already printed out the forms to gather your data click on: 2010 Diabetes Mellitus Measure Group Chart Review Form. 8

9 Gather Your Data Once you have gathered your data you will have to go back through the login procedure. Please review slides

10 Now you should see Faxed Received at the top of your page. You must submit data for any 30 unique patient charts. With two (2) of them being Medicare Fee for Service patients. For the Diabetes measure group the patients must be between the years of to qualify. It is of the upmost importance that all the information you gather for your patients is documented in their charts! CMS requires all registries participating in PQRI to conduct random audits. If you are selected you will be required to provide documentation (lab reports, office notes, etc) for each question asked in the measure group for some of the patient data submitted. 10

11 Click Add Patient to start entering your data You will get a new screen. When you get this screen you will either need to change the Patient ID to your office Patient Number or document on your visit form the number it automatically assigns them. Once you enter the diagnosis code it will give the second part of the screen. If you answer No it will take you to the next question. If you answer Yes it will ask you for the levels. 11

12 Once you have entered all of the necessary data press Submit. Continue adding patient information until you have your 30 patients entered. As you enter your patient data you will notice that it will track how many patients have been entered. It will also track the number of Medicare patients. Once you have all of the patient data entered click Next to continue 12

13 Before you submit your data be sure to print this page for your records and review your information. Once you have submitted your information it will give you a certificate of completion. Be sure to print this for your records. Congratulations! You have just successfully completed PQRI. 13

14 To access your feedback reports go to: /pqri_home/212 14